Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China

Abstract Background Neisseria meningitidis (Nm), traditionally recognized as a nasopharyngeal commensal causing invasive meningococcal disease (IMD), has recently emerged as an etiological agent of urethritis worldwide, with sporadic urogenital cases in China raising epidemiological concerns. Method...

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Main Authors: Qinghui Xie, Yang Yang, Wenwen Xu, Dandan Yang, Jingrui Li, Yijie Tang, Lingyun Shen, Fangyuan Yu, Wenhao Weng, Fuquan Long, Qingqiong Luo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Annals of Clinical Microbiology and Antimicrobials
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Online Access:https://doi.org/10.1186/s12941-025-00810-x
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author Qinghui Xie
Yang Yang
Wenwen Xu
Dandan Yang
Jingrui Li
Yijie Tang
Lingyun Shen
Fangyuan Yu
Wenhao Weng
Fuquan Long
Qingqiong Luo
author_facet Qinghui Xie
Yang Yang
Wenwen Xu
Dandan Yang
Jingrui Li
Yijie Tang
Lingyun Shen
Fangyuan Yu
Wenhao Weng
Fuquan Long
Qingqiong Luo
author_sort Qinghui Xie
collection DOAJ
description Abstract Background Neisseria meningitidis (Nm), traditionally recognized as a nasopharyngeal commensal causing invasive meningococcal disease (IMD), has recently emerged as an etiological agent of urethritis worldwide, with sporadic urogenital cases in China raising epidemiological concerns. Methods Three urogenital Nm isolates were characterized to investigate their evolutionary features and transmission patterns. Through comprehensive laboratory characterization encompassing culture identification (Gram staining, oxidase testing, MALDI-TOF MS), antimicrobial susceptibility profiling, whole-genome sequencing, and functional colonization assays on urethral epithelial cells under nitrite-supplemented microaerobic conditions, three multidrug-resistant Nm isolates were identified. Results All isolates demonstrated resistance to penicillin and sulfamethoxazole/trimethoprim, with isolate 24-SHSP-NM2 exhibiting additional ciprofloxacin resistance. The resistance was attributed to penA variants, mtrR promoter mutations, and gyrA substitutions. Phylogenetically, one isolate clustered with Japanese ST-11,026 strains and 2 clustered with Australian ST-1466 strains. Genomic characterization identified complete denitrification operons (aniA-norB) in all three isolates, which enable nitrite-enhanced epithelial colonization. ST-1466 isolates showed meningococcal B (MenB) vaccine component FHbp antigenic homology through FHbp variant 1.1. Conclusions These findings collectively demonstrate the convergent evolution of urogenital tropism, antimicrobial resistance (AMR) emergence, and metabolic adaptation to genitourinary microenvironments, underscoring the threat of genitourinary Nm infections. The study highlights the critical need to enhance molecular surveillance, implement rapid AMR screening, and prioritize MenB vaccination strategies in high-risk populations.
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spelling doaj-art-a670ea4e768f4eb9b4e29b11457d608b2025-08-20T03:04:26ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112025-07-0124111010.1186/s12941-025-00810-xCharacteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of ChinaQinghui Xie0Yang Yang1Wenwen Xu2Dandan Yang3Jingrui Li4Yijie Tang5Lingyun Shen6Fangyuan Yu7Wenhao Weng8Fuquan Long9Qingqiong Luo10Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Clinical Laboratory, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Sexually Transmitted Disease, Center of Infectious Skin Diseases, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityDepartment of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityAbstract Background Neisseria meningitidis (Nm), traditionally recognized as a nasopharyngeal commensal causing invasive meningococcal disease (IMD), has recently emerged as an etiological agent of urethritis worldwide, with sporadic urogenital cases in China raising epidemiological concerns. Methods Three urogenital Nm isolates were characterized to investigate their evolutionary features and transmission patterns. Through comprehensive laboratory characterization encompassing culture identification (Gram staining, oxidase testing, MALDI-TOF MS), antimicrobial susceptibility profiling, whole-genome sequencing, and functional colonization assays on urethral epithelial cells under nitrite-supplemented microaerobic conditions, three multidrug-resistant Nm isolates were identified. Results All isolates demonstrated resistance to penicillin and sulfamethoxazole/trimethoprim, with isolate 24-SHSP-NM2 exhibiting additional ciprofloxacin resistance. The resistance was attributed to penA variants, mtrR promoter mutations, and gyrA substitutions. Phylogenetically, one isolate clustered with Japanese ST-11,026 strains and 2 clustered with Australian ST-1466 strains. Genomic characterization identified complete denitrification operons (aniA-norB) in all three isolates, which enable nitrite-enhanced epithelial colonization. ST-1466 isolates showed meningococcal B (MenB) vaccine component FHbp antigenic homology through FHbp variant 1.1. Conclusions These findings collectively demonstrate the convergent evolution of urogenital tropism, antimicrobial resistance (AMR) emergence, and metabolic adaptation to genitourinary microenvironments, underscoring the threat of genitourinary Nm infections. The study highlights the critical need to enhance molecular surveillance, implement rapid AMR screening, and prioritize MenB vaccination strategies in high-risk populations.https://doi.org/10.1186/s12941-025-00810-xNeisseria meningitidisUrethritisWhole-genome sequencingAntibiotic resistancePhylogenetic analysis
spellingShingle Qinghui Xie
Yang Yang
Wenwen Xu
Dandan Yang
Jingrui Li
Yijie Tang
Lingyun Shen
Fangyuan Yu
Wenhao Weng
Fuquan Long
Qingqiong Luo
Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
Annals of Clinical Microbiology and Antimicrobials
Neisseria meningitidis
Urethritis
Whole-genome sequencing
Antibiotic resistance
Phylogenetic analysis
title Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
title_full Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
title_fullStr Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
title_full_unstemmed Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
title_short Characteristics of Neisseria meningitidis isolated from patients with urogenital infection in a region of China
title_sort characteristics of neisseria meningitidis isolated from patients with urogenital infection in a region of china
topic Neisseria meningitidis
Urethritis
Whole-genome sequencing
Antibiotic resistance
Phylogenetic analysis
url https://doi.org/10.1186/s12941-025-00810-x
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